The proposed research will examine treatment and utilization patterns for concomitant anxiety and depression in Medicaid primary and specialty mental health care settings. Further, the study will provide the first test of a modified treatment algorithm for measuring adequacy of mental health treatment in a Medicaid health care system. This proposal was motivated by the absence of data on anxiety disorders treatment patterns in Medicaid. Specific research goals will address effects of treatment sector and depression comorbidity on utilization patterns and treatment adequacy for Florida Medicaid beneficiaries who used health care services and had a provider-recognized anxiety disorder during FY 1999-2003. These aims will allow examination of hypotheses regarding effects of primary care use and presence of comorbid depression on the likelihood of receiving adequate mental health treatment. The proposed study has the potential to contribute to the health care system in a number of ways. Medicaid has become the largest provider of mental health care services in the United States and individuals eligible for Medicaid have disproportionately higher rates of psychological disorders. This study will describe the current treatment burden of anxiety disorders, as they are currently recognized and diagnosed in Florida Medicaid. A methodology to review the quality of care provided in Medicaid will be advanced by the proposed study. A systematic approach, grounded in clinical psychology and health services research, is necessary for the generation of mental health policy that incorporates both micro and macro level data on anxiety disorders health care use and treatment.